Radiation Oncology, OB.

I spent Wednesday morning in radiation oncology. It was pretty much what I expected - essentially, an assembly line of cancer patients herded into the machines, given terrifying amounts of radiation, and herded out. Dr. V was a bit of a creep, but he did give me a thorough explanation of how the oncologists and dosimetry specialists use CT scans and virtual CT scans to direct the radiation beams to precisely target a tumor.

The first patient we saw was a 71-year old man with prostate cancer. He was in the middle of his radiation therapy course, and there were no obvious tumor cells on the CT scan, but Dr. V said that his cancer was probably microscopic at this point, so the radiation was necessary to eradicate as much of the cancer as possible.

The next patient was a sweet old woman who had a mass in her sinuses which had crossed the skull and was infiltrating the area around her pituitary by way of the optic nerves. The woman had initially seen her doctor when she started having double vision, but other than a few moderate sinus headaches a few months ago, she had absolutely no signs or symptoms of her developing tumor. Unfortunately, the tumor's placement made it inoperable, so she was undergoing both chemotherapy and radiation in an attempt to limit the size of the mass and reverse its growth. She seemed in good spirits, all things considered - I can't say that if I had brain cancer I'd be quite as calm.

I spent about an hour with the department's radiation physicist, who is in charge of calibrating the radiation machines and planning brachytherapy procedures. Brachytherapy, for those that don't know, is a radiation technique which involves implanting "seeds" of a radioactive material inside a patient's body for a period of time. The advantage to using these internal radiation sources is that the dosage of radiation can be ramped up significantly, which usually means that the patient gets better faster. Dr. W showed me the ultrasounds of a man with prostate cancer who was being treated with I-125 seeds. The seeds themselves are quite tiny (about 3 mm long), and this particular patient had maybe 30 seeds implanted in his prostate. It was pretty cool, and I was invited to watch the implantation procedure in the OR the next time they have a case.

In the afternoon I made my way up to the labor and delivery unit. Lucky for me, there was absolutely NOTHING going on - no labors, no babies, nada. I wasn't exactly disappointed - I'm sure delivering babies is fun, but after watching ten million "OMG We're having a BAYBEEEE!!!11" shows on TV, I doubt I'd be all that thrilled to just observe a birth. Anyway, after hanging around the ward for an hour, I told the nurses I'd come back another day and left. +1 for me.